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Efficacy of dapagliflozin in improving arrhythmia-related outcomes after ablation for atrial fibrillation: a retrospective single-center study

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Abstract

Background

Atrial fibrillation (AF) is a widespread type of sustained arrhythmia that poses significant health risks. Catheter ablation is the preferred treatment; however, arrhythmia recurrence remains challenging. Sodium-glucose co-transporter 2 inhibitors, particularly dapagliflozin (DAPA), have exhibited cardiovascular benefits. However, to date, the influence of these inhibitors on AF post-ablation remains unclear.

Methods

We analyzed the records of 272 patients who underwent catheter ablation for AF from January 2018 to December 2022. Patients were divided into the control (n = 199) and DAPA (n = 73) groups based on DAPA prescription post-ablation. The primary outcome was total atrial arrhythmia recurrence after a 3-month blanking period.

Results

The mean age was 72.19 ± 5.45 years; 86.8% of the patients were men. At 18 months post-ablation, 36.2% and 9.5% of the patients in the control and DAPA groups, respectively, reported atrial arrhythmia. Multivariate analysis revealed that DAPA use was associated with a significantly reduced risk of arrhythmia recurrence (adjusted hazard ratio [aHR]: 0.15, 95% confidence interval [CI]: 0.07–0.32, p < 0.001). After propensity score-matching (PSM) in 65 pairs, arrhythmia recurrence was lower in the DAPA group compared with the control (8.3% versus 30.8%, aHR: 0.17, 95% CI: 0.06–0.51, p = 0.002). Freedom from total arrhythmia recurrence was significantly higher in the DAPA group compared with the control group in both the overall and PSM population (log-rank test p < 0.01).

Conclusion

DAPA administration post-ablation was associated with significantly reduced atrial arrhythmia recurrence rates, indicating its potential as an adjunct therapy for enhancing the success of AF ablation.

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Funding

This study was supported by the VHS Medical Center Research Grant from the Republic of Korea (grant number VHSMC23021).

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Veterans Health Service Medical Center, (05368) #53 Jinhawngdo-Ro 61 Gil, Gangdong-Gu, Seoul, Republic of Korea

    Hyeong Jun Noh, Sung Joo Cha, Chee Hae Kim, Suk-Won Choi, Chang Hoon Lee & Jin Kyung Hwang

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  1. Hyeong Jun Noh
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Correspondence to Jin Kyung Hwang.

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Noh, H.J., Cha, S.J., Kim, C.H. et al. Efficacy of dapagliflozin in improving arrhythmia-related outcomes after ablation for atrial fibrillation: a retrospective single-center study. Clin Res Cardiol 113, 924–932 (2024). https://doi.org/10.1007/s00392-024-02389-3

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